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20099 Apersonal statement, résumé, and recommendation are required. Please refer to page 5 of this booklet. Icertify that all of the information provided by me or on my behalf in support of my application for admission is complete and accurate. I acknowledge that I am obligated to supplement my application as soon as I know or reasonably should know if the information I have provided or that was provided on my behalf is inaccurate or incomplete. I also certify that the personal state-ment submitted in support of my application for admission is solely my own original work. I acknowledge that Pace University may, at its sole discretion, verify any information submitted in conjunction with my application. I acknowledge that if I omit relevant information or provide inaccurate information or information that is misleading, submit a personal statement that is not solely my own original work, or of I fail to supplement my application as required, Pace University may, at its sole discretion, deny my application for admission, rescind my admission, impose disciplinary sanctions against me, dismiss me from Pace University, and/ or rescind any degrees or certificates awarded to me by Pace University. Iacknowledge that the application fee I have paid or will pay in the future is not refundable. Iacknowledge that I am bound by the policies, practices, and procedures of Pace University, whether published or unpublished, and I agree to comply with them. Applicant's SignatureDate( MM/ DD/ YYYY) Please print name // APPREC DATE( MM/ DD/ YYYY) // FEE REC DATE( MM/ DD/ YYYY) FOR OFFICE USE ONLY Institution Attended City State // Start Date( MM/ YY) End Date( MM/ YY) Degree Received: Associate's Master's Bachelor's None Please list in chronological order all colleges or universities attended since your high school graduation. Be sure to include all institutions at which you were, are, or will be enrolled prior toyour anticipated Pace University graduate program entry term, not only those institutions from which you received a degree. Anofficial transcript from each institution must be received bythe Pace University Office of Graduate Admission to which you are sending this application. All documents not issued in English must be supplemented by professionally certified English translations ( please see International Student Information). Country / Date or Expected Date ofDegree( MM/ YY) Institution Attended City State // Start Date( MM/ YY) End Date( MM/ YY) Degree Received: Associate's Master's Bachelor's None Country / Date or Expected Date ofDegree( MM/ YY) Institution Attended City State // Start Date( MM/ YY) End Date( MM/ YY) Degree Received: Associate's Master's Bachelor's None Country / Date or Expected Date ofDegree( MM/ YY) Institution Attended City State // Start Date( MM/ YY) End Date( MM/ YY) Degree Received: Associate's Master's Bachelor's None Country / Date or Expected Date of Degree( MM/ YY) Institution Attended City State // Start Date( MM/ YY) End Date( MM/ YY) Degree Received: Associate's Master's Bachelor's None Country / Date or Expected Date of Degree( MM/ YY) Have you ever been placed on academic or disciplinary probation or been dismissed from any institution? If yes, please attach your statement of the circumstances. YesNo Non- Discrimination Statement Pace University prohibits and will not tolerate discrimination or harassment in any of its programs or activities on the basis of sex, race, color, national origin, religion, creed, age, dis-ability, citizenship, marital status, sexual orientation, genetic predisposition or carrier status, veteran status, or any other characteristic protected by law. Pace University's Affirmative Action Officer has been designated to handle inquiries regarding the University's non- discrimination and harassment policy and may be contacted at 156 William Street, New York, New York 10038, ( 212) 346- 1310, or at Costello House, 861 Bedford Road, Pleasantville, New York 10570 ( 914) 773- 3856. Reasonable Accommodations Pace University prohibits discrimination on the basis of disability and is committed to ensuring equal access to the application process for applicants with disabilities. An applicant who may require a reasonable accommodation in order to complete the application process should contact the Director of Disability Services on either the New York City ( 212) 346- 1526 or Pleasantville campus ( 914) 773- 3710.